Provider First Line Business Practice Location Address:
420 E THIRD ST
Provider Second Line Business Practice Location Address:
SUITE #1008
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-625-7141
Provider Business Practice Location Address Fax Number:
213-625-7167
Provider Enumeration Date:
06/25/2007